title: Declining vision: saved by a tracheostomy.
abstract: A 37-year-old woman presented to our hospital with a history of headaches, blurred vision and declining visual acuity. She had a history of obstructive sleep apnoea associated with Treacher Collins syndrome, a rare congenital disorder characterised by craniofacial deformities and obstruction of the upper airways. On funduscopy we noted bilateral papilloedema and retinal haemorrhages. A CT scan of the brain excluded a space occupying lesion and contrast-enhanced CT did not show evidence of venous sinus thrombosis. The cerebrospinal fluid opening pressure on lumbar puncture was normal. We made a diagnosis of visual loss and papilloedema secondary to chronic CO2 retention from obstructive sleep apnoea. Her vision and headaches improved remarkably following a permanent tracheostomy. This case highlights the association between obstructive sleep apnoea and papilloedema and shows that the associated visual loss can ultimately be restored with a tracheostomy.
authors.affiliation: Department of Medicine, Prince Charles Hospital, Merthyr Tydfil, UK.
authors.forename: Kirsty L
authors.initials: KL
authors.lastname: Hett
authors.forename: Lily J
authors.initials: LJ
authors.lastname: Chutter
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassan
authors.forename: Onyebuchi E
authors.initials: OE
authors.lastname: Okosieme
mesh_terms: D000328:Adult; D005260:Female; D006261:Headache / Q000150:complications / Q000628:therapy*; D006801:Humans; D008342:Mandibulofacial Dysostosis / Q000150:complications; D010211:Papilledema / Q000150:complications* / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014139:Tracheostomy; D014786:Vision Disorders / Q000209:etiology* / Q000628:therapy*; D014792:Visual Acuity